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British Journal of Anaesthesia, Vol 82, Issue 3 371-373, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Relative potencies of bupivacaine and ropivacaine for analgesia in labour

G. Capogna, D. Celleno, P. Fusco, G. Lyons and M. Columb
Department of Anaesthesia and Department of Obstetrics and Gynaecology, Fatebenefratelli General Hospital, Isola Tiberina 38, I-00186 Rome, Italy; Department of Anaesthesia, Ospedale S. Giacomo in Augusta, v. Canova 29, I-00186 Rome, Italy; St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK; Intensive Care Unit, Withington Hospital, Nell Lane, Manchester M20 2LR, UK

We have used the technique of randomized, double-blind sequential allocation to compare the minimum local analgesic concentrations (MLAC) of epidural bupivacaine and ropivacaine for women in the first stage of labour. The test bolus was 20 ml of local anaesthetic solution. The concentration was determined by the response of the previous woman to a higher or lower concentration of local anaesthetic, according to up- down sequential allocation. Efficacy was assessed using a 100-mm visual analogue pain score (VAPS). The test solution had to achieve a VAPS of 10 mm or less to be judged effective. For bupivacaine, MLAC was 0.093 (95% CI 0.076-0.110)% w/v, and for ropivacaine, 0.156 (95% CI 0.136- 0.176)%w/v (P < 0.0001, 95% CI difference 0.036-0.090). The analgesic potency of ropivacaine was 0.60 (0.47-0.75) relative to bupivacaine. Claims for reduced toxicity and motor block must be considered with differences in analgesic potency in mind.
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